Breast Cancer Action

coming up on this focus with health. our team sharing life saving information about breast cancer. chances are there's not a single person whose life hasn't been touched. statistics show 1 in eight women â 

will develop cancer in their lifetime. we will hear from medical professional and women profiling their stories of hope and survival. don't go anywhere, this focus report starts now. focus is the people, places

and issues that matter to you. everybody has a story. these are the stories that uplift and inspire right here in your neighborhood. focus on what matters. you never know what you're going to see when you tune into to focus.

support it provided by: by supporting education and the arts, air products hopes to strive the lehigh valley where whose is winning and who is losing. the full range of the human experience playing out every day in the page of our newspaper and

website. the platform you choose to engage with you is your business. delivering the news is ours. thank you for joining us for this special focus on health. i'm laura mchugh. next to skin cancer, breast

cancer ranking at the hop. about 40,000 women will die for it. as we learn, about five to 10% of breast cancer is thought to be hereditary. brittany garzillo with the story. the surgical procedure of

removing one or both breasts and has become a popular method and can reduce the risk the breast cancer 90%. one courageous woman add us her name to the list. that's when we were a little. in her severe mountain side house.

kelly and her sisters take a stroll down memory lane. it's an afternoon full of family and fond memories. look. behind their sincere smile system a family history not quite as pleasant. three of her four sisters were

diagnosed with it and her mother passed away with it. when you have sisters and a mother, you figure the shoe is going to drop. it was revealed that kelly inherited the brch 1 or braco 1 strain. once i got the positive

test, i'm like what should i do? i don't think we were surprised because three of us had been diagnosed. the biggest surprise was kelly was diagnosed. hiking, biking and white water rafting, her active lifestyle doesn't leave room for

cancer. she headed to saint luke's to discuss the options. i work with individuals who are at high-risk to develop cancer or who may have cancer. according to andrea, the braco 1 gene affects about 10%. she who has a family history,

multiple realms of ovarian or bilateral or individuals with other forms of cancer. if i understood then what i understand now about the information from the genetic testing could help me make choices to prevent a breast cancer diagnosis, i would have

taken action then. i decided to be proactive. after consults with dr. lee reilly at saint luke's, kelly weighed her options. taking an antihormone or opting for a new procedure. a prophylactic mastectomy. it's removing both breasts.

prophylactic means you don't have cancer yet. those women can under go no reconstruction or under go various types of reconstruction. kelly made the courageous decision to under go a prophylactic reconstruction and gives are from 80% chance to one

%. the brac genes were only identified in the last several years. it identifies women at high risk. kelly's decision mirrors that of hollywood actor angelina jolie who went public about her

decision to take the action. if she had been the person speaking three or four years ago when i was first being advised to have genetic testing, i would have perked up and listened and maybe i would have done the same thing and avoided this breast diagnosis.

dr. reilly says the prophylactic mastectomy isn't for everyone. i think cancer changes your life. you realize what's important. your priorities change. you don't sweat the small stuff anymore.

with kelly, she's a great example of that. she really does full life. for focus, i'm brittany garzillo. earlier, natalie tested positive for graco and began to block at natalie's journey.com. welcome here natalie.

thank you for being here. i experienced abnormal bleeding and wasn't a major concern, i was due for a doctors appointment which is something i hadn't been good about most of my life. taking care of the physical aspects.

i stumbled on dr. tailor and read recommendations he was a great doctor. i had also known someone that went to him and had a positive experience. i made an appointment. he asked me questions that i hadn't thought about as far as

family history which includes cancer on both sides. so he had thought with the abnormal bleeding and some of the thing we found on my ovaries, it would be a good idea for me to take the braca test. i had been familiar because of angelina jolie.

i found how the my insurance covered it. what did you find out? even with my family history, i wasn't too concerned. i lived in denial not thinking of my health. i was surprised when the results came back that i had an 87%

chance of developing breast cancer and a 50 percent chance of developing ovarian cancer. 50% is like flipping a coin and 87% is as close as to a hundred percent that you want to here. upon hearing how quickly i reacted to the news and started

a game plan. that was to stay cancer free and to go about that with the help of my doctors and researching my different options for myself. the one thing that i stress and i learned through this experience is, educating yourself.

being your own patient advocate. not going into this blindly. so, i decided for myself as a personal decision to go ahead and get a total hysterectomy that could lower my chances and a double mastectomy. for me, it was a no-brainer. i knew they were options, but

for me, my decision was to do the surgery. how long did you grapple with that decision? it was an instinct for me. i am a single parent. i went into mom mode and survival mode and knew i had to be here to take care of her.

knowing this would be the best option as far as lowering my risk was an instant decision. you brought up your daughter in "knowledge is power". you talked about the guilt of passing this to your daughter and i imagine that's a common feeling.

how are you doing with that? that's a really good question and i talk about that in my blog. through this experience, that's probably the most difficult thing for me to deal with. the guilt i feel knowing i have passed this on to my daughter.

i'm not sure of the percent chance she has of getting this, but know it could be in her future. one of the things i focus on now is not just changing the future of my house and the outcome of this situation, but focusing on the outcome of my daughter's

doing the things that could keep her from hearing she has this threat of disease. has she considered whether or not she will get tested yet? she has been my biggest supporter. she is right behind me and supports me getting the

surgeries and she has said that if, when the time comes for her, which will probably be in her early 20's, she will take the test too. she knows that eating right and exercising will help the outcome of that test. because she's how old now?

12. an age she's going through a lot of changes now. yes. this is a difficult situation. it's not as difficult as it could be for someone with a cancer diagnosis. she's getting to see this and

how i handle this which is why i am making sure i educate myself and share with other women. natalie, one of the things i said was you look so beautiful. you changed your hair. through having the total hysterectomy. there are side affects due to

the hormone levels and one thing i have experienced is hair loss. i opted to get new hair and i feel lucky that's my only worry at this point. you had your hysterectomy, what is the next step? i see my plastic surge on wednesday, october 2nd.

we will discuss the options as far as reconstruction and what he recommends at this point. so i look forward to that. i will be sharing that with my readers as well. and we can follow, continue to follow your journey at natalie's journey.com.

i will be honest. sharing the different aspects of this and the progression. why did i decide to make it public? this journey of yours? i decided this probably as quickly as i did my decision to have the surgeries.

i felt the angelina jolie situation was wonderful because she put this out there. however, i thought i would take it a step further and show everyone not only the test is available, and what she looked like afterwards, but step by step how this affects you.

the decisions that have to be made. the choices you have. so i just felt it was a chance of responsibility that i had to follow. thank you so much for sharing this natalie.

thank you. for sharing on air and online and on your blogs. for women who don't have known risk factors or can't control the ones you have. the annual mammogram starting at age 40 are recommend. grover silcox shows what's

available in our area. when a woman develops breast awareness to develop lumps or any changes, she goes a long way in preventing and even beating i spoke with a radiologist and a cancer survivor at lehigh valley on the most advantaged techniques and here's what they

had to say. legions of women are affected by breast cancer every year, they know the annual mammogram is important. in june of 2012, june learned she had cancer. it was from a mammogram. i never would have detected it.

the mammogram is a two-dimensional photo of the breast. the american cancer society recommended women over 40 get one every year. the screen picked it up and the doctors called me back. we went through ultrasound and

it was positive. doctor prya sarein served on the medical team that diagnosed and treated cancer. when she came in, it was a very small area of calcification. my tumor was so small the only way to detect it was a

screen and mammogram. the problem is by the time a patient can typically feel something, about a centimeter, it's already bigger. sometimes if they don't feel about it at two, you worry about it going to the lymph nodes. it was detected very quickly.

she underwent surgery and chemotherapy and now her cancer is in remission. although mammography can save lives, it can miss cancer in women with thicker breast tissue. this takes multiple images and allows us to see through

denser portions of the breast and whether or not it's a benign it generates twice the radiation. taking different levels of a it's kind of like a cat scan. the center has been able to rule out cancers who might otherwise would have taken tests

in the meantime, they recommend women schedule yearly mammograms and checkups. i can't stress that enough. screening and mammography is the only test that has saved lives. don't be afraid of being tested. it's your fear that will hurt

you more so. take it from joan edwards. one of millions who battled and won against breast cancer. for focus, i'm grover silcox reporting. to continue this discussion about 3 d mammography. doctor laura burgess joins us

now. when we talk about 3 d mammography, what is the difference. we started with regular film mammography and now moved to digital, which is the standard of care. now we have 3 d or tomo

synthesis. a computer assimilates these into one big image and poses an image to read. the benefit of 3 d over digital or an log is that you get a much clearer, more distinct and defined picture of the breast tissue, so it enables us to find

smaller tumors at an earlier stage, which was obviously what we want in a screening test. so what are the benefits of it getting that early? the diagnosis that early? so obviously, the sooner we catch it, the less treatment that is required and the less

chance of it spreading to other parts of the body and makes it easier to treat for the patient now, who is going to be a good candidate? anybody can benefit from the 3 d mammography, however the people that benefit are women with dense breast tissue.

that tends to be the younger patients. usually people under the age of 50. but you can have an older woman with dense breast tissue who will still benefit from this technology. obviously, breast cancer

survivors, we like to use the technology on them. since they developed the disease initially, they are at risk for developing a recurrence. how often should they have this screening? so screening is really across the board starts at age 40 and

every year thereafter. once they get through their first year, they go through annually like everybody else. we hear recommendations how often people should be screened so the u.s. task force posed new screening recommendations, but nobody has adopted those.

they were not to start until the age of 50 and to go every other year and the american cancer society and pretty much the medical profession does not feel comfortable with those recommendations. there's a significant number of women under the age of 50 who

are diagnosed with breast so, if you have significant family history, what does that mean? it means primary or first degree relatives. mom or sister who had breast cancer at an early age. for us, the definition of early

stage breast cancer is under the age of 50, you need to start your screening 10 years before that. if your mom had cancer, you need to start your screening at 33. what other risk factors as they look -- considering starting earlier.

if you have fibrocystic breasts. you might have cat scans as well. what are the survival rates for breast cancer. they approach 1 hundred % with early stage breast cancers. it's not the date sentence

people thought of 20, 30, 40 years ago. therapy and prognostic factors has changed. how does this aid you in your ability to remove these? it's great for me because i get to offer the patients breast conservation, lumpectomy instead

of mastectomy. where is that line? and where you make the lines? there's not a hard and fast rule. if you have a large tumor in a small breast, it wouldn't be an option. if you have large breast, you

can tolerate a bigger section and still have breast conservation. how long have you been training? i started in 2002. 10 years. so where does this live on the latest technology.

the cleveland institution came out with the list of premiere technology and it was number nine. how widespread is the use? it's not standard of care yet. insurance companies are not covering the full cost.

blue cross just approved covering that cold on september 9th i am sure the others will follow. each facility came up with a fee out of pocket. easton hospital is charging $45 and are institutions might charge 50 or $60.

if you're not really strapped, $45 is not a big cost to have better piece of mind. doctor burgess. thank you so much for being if you're just joining us from this focus special report, we're covering eight the basis on breast cancer.

we learned about the latest screening technology in our reading and brittany garzillo is here to talk to us about the newest treatment. interoperative therapy may save women weeks of therapy. this is saint luke's chief of oncology.

thank for having me. it's called interoperative radiation therapy. tell us about it. it's typically what we do is treat women for six weeks after they have breast cancer if they have a lumpectomy. we have a device in the

operating room where we take the lump out and put this blastic ball this. shoot radiation, take the ball out and add an incision. it prevents the weekly treatment for six weeks. what kind of women are candidate

candidates? they did a study where women flipped a coin and half got six weeks of radiation therapy and half of them got the one day. you could be as young as 45. you had to have relatively early so smaller, about an inch is the average size.

and had to have favorable features. we didn't think it was a really aggressive cancer. that's a pretty common cancer type. as we do this at st. luke's we starting out more safe. we have conservative criteria.

no nothing really set in stone. we like it not to be in the lymph nodes and smaller tumors in the age of women over 60, 65 in that range. if you look around the country. everybody is doing it relative different. california, they will treat

women who are 45. so it's just where their comfort zone is. the best thing is to consult with the physicians first to determine if they're candidate. exactly. and everybody has different

needs and criteria. it's really an individual thing. how does this compare and surgery and radiation? typically, you go through surgery. you go home that day. we check an lymph node.

usually, people are back to work within a week. no sooner than three weeks we start radiation therapy where they come into the radiation facility, lay down on a table. get a couple tattoos that are very small. the next day they come in and

it's sort of like going to a tanning salon. but it only takes a minute to get the treatment when you get your daily dose. then you have to do that monday through friday for six weeks and that's a big inconvenience. the breast starts to turn red

after two weeks. most women don't blister but some can. after two weeks after you're finished, the redness goes away. it's six weeks of treatment has it been tested along enough to understand the survival rates?

depends. for any treatments, we started doing it with the lumpectomy and started adopting the therapy. then continue years later, we do another study and see how those women are doing and another 15 years and a study. typically we adopt things at a

five-year interval. we're just reaching that now. when it first came out. they were people four years and others that had been for a long time. we're in the ballpark with this. the lumpectomy was 1 percent. they are statistically

identical. we will follow them out for many, many years. how is this changing the life of cancer patients? it's dramatic. the people going through it don't know what they are missing.

i try to tell my patients because they were still getting the six weeks. i said there's going to be a new technology out here that's not available but if you hear about it, i wish we had it sooner. they are grateful for the women coming after them.

things are changing and makes the whole field encourage we are making need strides. now do you foresee using this kind of treatment to treat other cancers besides breast cancer in the future? i do. at organizations like md

anderson memorial, they have been using radiation therapy in the operating room. they have the whole linear accelerator accelerators. they see if you can treat the lung or rectum. this makes it easier and more

portable so you don't have to have a $3 million machine inside an operating room. yes , i see it. there are studies that have come out this device with rectal it's coming. now in fewer than 50 sites offer the technology.

this is something extremely rare to lehigh. it's the only one in pennsylvania. i don't think there's one in new jersey. i'm going new york tomorrow to look the the area where they are doing it a lot.

they have been doing it, and i see it coming. the 50 sites is not like we're the first on the block. but it's out there and i see it coming. well, the technology just amazing. doctor lee reilly from saint

lukes. thank you so much. laura. according to our next guest, finding the right treatments for the right person leads to a greater survival rate. welcome dr. catherine harris and jennette plow.

what do you mean finding the right treatment? the parameters we used to use are not the be all end all. there's a lot to learn about tumors and if our treatments are going to have significant impact. we always thought of breast

cancer as one disease. it's become clear there are multiple types of breast cancer. every patient and tumor are unique. how do you identify the right treatment for the right person? it's a multi-step process. meeting the patient and what

they intend to get out of treatment they receive. looking at the specific factors of their disease. the stage, how far along the tumor is and more sensitive factors like dr. harris alluded to. the actual biology of the tumor

to guide the treatment. is there guidance you use when you decide what i think of as surgery, chemo. surgery is often the first step to remove the tumor and give us an accurate stage to guide the treatment. systemic therapy such as what

doctor harris delivers and radiation treatment primarily geared toward local control. keeping the cancer from coming back to the original site and survival benefits from treatment what are systemic treatment? in breast cancer, the two treatments are chemotherapy or

anti anti-es anti-estrogen therapy. it used to be years ago we were much more likely to give chemotherapy to more women, but as we followed patients along for many years, it's clear that over the long-term, there can be

some unexpected long-term consequences of chemotherapies, such as cardiac disease, secondary cancers, and other very life-threatening illnesses. we have been trying to figure out who really needs aggressive treatment and who really doesn't need those sorts of treatment so

they are not subjected to the short and long-term side affects. if somebody found early stage. since staging is a key factor in identifying the treatment, what is the typical treatment versus someone as a very advanced

stage? we're big proponents of breast conservation. being able to save the breast and treat it for the equivalent outcome which mastectomy used to be recommended. it will involve partial breast surgery, followed by some form

of drug therapy and radiation treatments to treat the remaining breast tissue to prevent recurring cancer in the lymph nodes. trying to shorten of the overall course so it's less cumber some and fitting with their life goals.

that's taking place in our field, the regiments that aren't so detrimental to the quality of life and reducing the long-term risks of radiation therapy. at what stage is mastectomy considered or looked at? there are a couple of indications that a mastectomy is

needed. for a patient who may not have an acceptable cosmetic outcome with a breast conserving mastectomy is one consideration. if someone it desirous of saving the breast, we will give hormonal therapy to shrink the tumor and allow for better

cosmetic surgery. that's at an absolute indicator, but certainly a consideration. times when mastectomy is preferred is when there's a tumor involving, we decide the breast up into a clock face and talk about quadrants. and if there's a tumor over

multiple quadrants, then really breast conserves surgery is not a safe surgery and our primarily goal is taking the best care of a mastectomy is the preferred reason. what percentage of breast cancer is resulting in mastectomy? that's a difficult question.

there are so many taken because of cancer phobia. there's a lot of media attention on cancer risk. sometimes younger women even if they are a candidate for keeping the breast, may opt to have the mastectomy to prevent dealing with cancer later in life.

and there is reconstruction which makes it a reasonable it's kind of a multi-part answer. not that we're seeing more advanced cancer. there has been a trend toward more aggressive surgery for those reasons

finally, how is it affecting survival rates being able to tailor treatment? breast cancer is a disease we have made progress. we identified particularly aggressive subtypes, development targeted therapies that kind of neutralize the proteins involved

in causing the aggressive nature of the cancer. and our treatments on average can reduce the risk of a recurrence. we talk about a recurrence, we're talking about the development of advanced met static disease by 50%.

compared to somebody who receives no treatment to reduce that risk. so, the other really nice thing is we are being more mindful of our survivors and paying attention to the long-term quality of life. being better able to identify

who needs aggressive treatment and we're finding that patients are living a better quality of live when they survive breast doctor harris and doctor nough. thank you for joining us. the affects of cancer don't just go away when they hear the

news they are cancer free. the surgeries and therapies that follow leave their bodies and lives charged forever. i met one local woman who battles a condition that affects many breast cancer survivors. years after joan beat cancer, she finds herself in the

hospital to treat the lasting affects of her cancer treatment. this arm is obviously very small. the shooting pain. once in a while, i get a shooting pain, uncomfortable swelling joins the pain. joan describes thes of

lymphademia. it's one thing that's unpreventible when you have i started getting it and my arm would swell. without lynph nodes to carry the extra fluid away from her body, she has to have treatment. two to three times a week.

joan comes to easton hospital where she spends an hour with carol whale from good shepard rehabilitati rehabilitation. you and i have a hang nail, get a bee sting. we don't pay much attention to for someone with disruption to

th lypmphatic disease. it's always the same spot so that everything is consistent. then kara moves on to manual lymphatic maage -- massage. it's to move the fluid to go back to the regular vascular system.

part of make its work, there's a normal muscle action pump in the arm. the more they use it, the more the muscle pushes against the bandages. break in the bandage a little bit. after she completes therapy,

joan will be fitted for a special compression sleeve. it's one of ways cancer may have changed her bad. but deep down, she's still the same person as always. to continue the conversation about life after cancer, easton hospital's marion kelly is with

us. thank you for being with us. thank you for having me. for a lot of breast cancer who is go through treatment, surgery, chemo. what is the next step after they hear they are cancer free? that's been a journey.

for some patients, it could be a year, several years if they are on hormone therapy and considered cancer free. from the day they are diagnosed, they are considered a survivor. we look at all that you made it and doing great through the whole treatment process.

when they have been discharged from their medical oncologist or surgery oncologist, they get scared and not sure how can i not do that without the follow up appointment? we see they get nervous about that and like the checkup because the fear of it might

come back. we see patients. we try to with our breast care nurse navigator and the nurses they have made contact with that we can keep them feeling healthy and doing the right thing when they go through that piece they are separated then from their

onicologist. i think that's the time they start to learn how to know that everything is going to be okay and they don't have to keep that thought always in the back of their mind. how often do they need to see their oncologist at this point?

most do want to continue to see their patients. it's usually yearly when they come back to the follow up. that's who is going to take care of providing them with having their mammograms done on that year basis and more frequently. physically and biologically,

for women that experienced breast cancer, their bodies are changed often forever. we saw it in the case of lymphedma. what are other ways their bodies are changed? if they have gone through chemotherapy with their hair.

they may have lost their hair and it's grown back and maybe a whole different texture. they might have had straight hair and it comes back early. they see that as a body change. that could be a life changing experience for them if they have had to have mastectomy and

reconstruction. so again, that's something that occurred to them they now have to forge forward. they always remember they are a survivor and have gone through this. they will adapt to the changes that occur.

some may have gained weight because of hormone therapy they have been on. they now have to learn how to do different type of exercising or way of eating that will be different than what they did prior to being diagnosed with having cancer.

it also changes them from the inside out too. it changes your life forever once you've born that word. once you're a survivor. we see that a lot. i think they already have a whole different outlook on life when they do that.

they want to live for the moment. i see many patients do things they never would have done if they hadn't been diagnosed. that's actually rewarding to a lot of patients and their families because they take on a whole different aspect of life

and go sky diving they probably never would have done that. something as daring as that or how they want to give back. i have a volunteers that are breast cancer survivors. that was the way to give back because so many gave to them am they come back and be

volunteers. they see that as an opportunity they probably wouldn't have done. a lot of times we hear about five year survival rates. is that five year mark a really important milestone for a lot of women?

you know, i think that continues to be. we really look at from the day they are diagnosed they are considered a survivor. we see treatment planning and if they have hormone, they might have been to be on for five statistically, we look at

five-year survival years. it's a number that has stuck and we continue to use as a marker. as easton hospital oncology services, what piece of advice do you for somebody that got the great news they are cancer free and being discharged. what advice do you have?

live the life, the best you can i think. just go for it. because there's no reason you shouldn't be able to enjoy and continue on and do everything you want to do and more. i mean i just think that you're blessed and you really need to

move forward. don't look back. just keep going forward. and give to others. i think that sharing and being able to be with others is like the most fun that you can do. marianne, thank you so much for being with us.

finally this past weekend, thousands of women and families came together for the women's 5 k classic. this started in 1993 with just 250 runners and walkers. 20 years later, it attracted 5000 women and raises $250,000 for support groups and

screenings for low-income women. maggie boyier brings us the sights and sounds from this event. we started actually 21 years ago. it was started to get women into fitness because women who exercise, there's studies they

are greatly reduced risk of developing breast cancer. when we did the event, we decided to link it with breast cancer because we thought people would be more motivated to celebrate the event and give if there was a cause. the best part of the event,

it's all about stories. stories about coming back year after year after year, meeting together in a special place in the lehigh parkway. i honestly, i knew that was the thing i should not be well, my sister had breast cancer and she was only 27, and

so, about 20 years later, i had ovarian cancer, so we won the sister award for having female and i am a six-year survivor. i have all my friends and family and kids here to support a very, very dear cause to my heart. it's the whole community for one day.

everybody is in the women's 5 k classic. we have every hospital in the area working together today. we've got a fantastic sponsor. it's everyone does something that makes this event successful. it takes a village.

to get things done. and actually this whole group 5000 lady, this is a village for lehigh valley. we are blessed to such a good organization. since 1993, the women's 5 k classic has raised more than $2 million for breast cancer

programs in lehigh. they support all kinds programs, whether to help low-income women get mammographies or programs to teach young women breast cancer support. a lot of support for people facing this scary prospect. every knows someone.

has family, friends who have faced it. my mother had a double mastectomy. i was only 13 years at the time. way back when and how frightening that is. all these new techniques giving hope to women is great.

it's amazing to hear 2.8 million breast cancer survivors. both of my grandmothers of it runs in my family too. the 3 d mammography. it's going to change the way people view and deal with and how quickly it changed.

i remember doing a story five years ago about digital mammography and now 3 d is the accepted way to go. some things never change. as natalie pointed out. you have to be your own best advocate and have the breast awareness or awareness of your

body to detect changes from tumors and lumps or discoloration. you're aware of your own body to identify these problems early on. thanks to natalie and brittany's reporting. previvor.

if they do something early and they do something to prevent thank you so much for your reports and your hard work. our next focus in health is not going to be until january until we focus on children's health. remember to focus on what matters.

focus is supported by: the arts. air products strive to improve the quality of life in the lehigh valley where we call